Using your private health extras for Speech Therapy and OT
Many extras policies include speech pathology and occupational therapy. How much you get back depends on your fund, your level of cover, and how much of your annual limit you have already used.
Here is how extras cover generally works, what to ask your fund before you book, and how claiming works at our Northmead clinic.
Speech pathology and occupational therapy usually sit under the extras (ancillary) part of a policy rather than hospital cover. Funds set their own benefit per session and their own annual limit, and both vary widely between policies.
Benefits are typically a fixed amount or a percentage of the fee, with the balance payable by you. Waiting periods often apply when you first take out extras cover or upgrade it.
Claiming an extras benefit is straightforward, and our client care team can help if anything is unclear:
You cannot claim a private health benefit and a Medicare rebate for the same appointment. Where a session is claimed against a Medicare pathway — a Chronic Condition Management Plan, for example — the gap payment cannot then be claimed from your extras cover.
What you can do is use different pathways for different appointments across the year. Many families use their Medicare-referred sessions first and move to extras cover once those services are used up. Our Medicare page sets out how many services each pathway allows, and our NDIS page covers self-managed and plan-managed plans.
On many extras policies, yes — but not all. Speech pathology and occupational therapy are usually separate categories on a policy, so if your child sees or may see both, check both.
Generally no. Extras claims do not usually require a GP referral, unlike Medicare. Your fund will confirm what it needs.
It depends entirely on your policy. Funds set a benefit per session and an annual limit. Call your fund with the service name and our fee and they can quote you the exact benefit — ask us for our current fees in writing if that helps.
Not for the same appointment. You can use one pathway for some sessions and the other for others across the year. See our Medicare page for how the Medicare pathways work.
You can keep attending as a private-fee client, or check whether a Medicare pathway or NDIS funding applies. Our client care team can talk through the options with you.
Related pages: Funding Options · NDIS funding · Medicare rebates · Speech therapy · Occupational therapy · Areas we serve
Last reviewed: 10 September 2026. Health fund benefits, annual limits and waiting periods are set by each fund and change from time to time. Always confirm your own cover directly with your fund.
Call your fund with our fee and the service name and they will tell you exactly what you will get back. If you would like our fees in writing first, just ask.
Call 9037 1163 or visit us at 7/185 Briens Road, Northmead NSW 2152.
